DEREK C POLONSKY M.D.
NPI 1992730220
Psychiatry & Neurology - Psychiatry in Brookline, MA

Active since July 12, 2006Opted out of Medicare · through Feb 16, 2028
1180 BEACON ST, SUITE 4C, BROOKLINE, MA 02446(617) 566-7508 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Derek C Polonsky M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK C POLONSKY M.D. (NPI 1992730220) is an individual psychiatry provider in Brookline, Massachusetts, licensed in Massachusetts (37465) and active in the NPI registry since July 2006. He has opted out of Medicare through February 16, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1992730220
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDEREK C POLONSKYCredential: M.D.
Location Address1180 BEACON ST, SUITE 4CBrookline, MA 02446-3885
Mailing Address185 Newton StWeston, MA 02493-2338 · (617) 566-7508
Sole ProprietorNo
Enumeration DateJuly 12, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1992730220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License Licensed in MA · 37465
Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

1180 BEACON ST, Brookline, MA 02446

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Derek C Polonsky M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 16, 2016 through February 16, 2028.

Opt-Out Effective DateFebruary 16, 2016
Opt-Out In Effect ThroughFebruary 16, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02446 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$189.86 typical visit price
range $63.72 – $189.86
Typical copayment $47.46 (range $15.93 – $47.46)
Most-billed visit code 99205
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
1180 BEACON ST
BROOKLINE, MA 02446
Internal Medicine
1180 BEACON ST, SUITE 5A
BROOKLINE, MA 02446
Internal Medicine
1180 BEACON ST, SUITE 8A
BROOKLINE, MA 02446
Podiatrist (Sports Medicine)
1180 BEACON ST, SUITE 4D
BROOKLINE, MA 02446
Internal Medicine
1180 BEACON ST
BROOKLINE, MA 02446
Physical Therapist
1180 BEACON ST, SUITE 6-C
BROOKLINE, MA 02446
Psychiatry & Neurology (Psychiatry)
1180 BEACON ST, SUITE 4C
BROOKLINE, MA 02446
Internal Medicine
1180 BEACON ST, SUITE 5A
BROOKLINE, MA 02446

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Polonsky's NPI number?

The NPI number for Derek Polonsky is 1992730220. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is Derek Polonsky located?

Derek Polonsky practices at 1180 Beacon St Suite 4C, Brookline, MA 02446. The listed phone number is (617) 566-7508.

What is Derek Polonsky's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Derek Polonsky enrolled in Medicare?

No. Derek Polonsky has opted out of Medicare through February 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Derek Polonsky was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.